Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
Am J Gastroenterol. 2010 Apr;105(4):876-82. doi: 10.1038/ajg.2010.75. Epub 2010 Feb 23.
We sought to evaluate colonic gas accommodation, ileocecal competence, and colonic clearance in subgroups patients with abdominal bloating.
Thirty-six patients complaining of abdominal bloating (12 constipation-predominant irritable bowel syndrome (IBS-C), 12 diarrhea-predominant irritable bowel syndrome (IBS-D), and 12 functional bloating) and 18 healthy controls were studied. Abdominal perception and girth were measured during: (i) 1 h continuous infusion of gas at 24 ml/min into the rectum (accommodation period) and (ii) 30 min free rectal gas evacuation (clearance period). In eight patients and eight healthy subjects, the gas infused was labeled with radioactive xenon (74 MBq (133)Xe), and gas distribution was determined by scintigraphy.
Colonic gas accommodation produced significantly more abdominal symptoms and distension in patients than in healthy subjects (3.8+/-0.2 vs. 2.4+/-0.3 perception score; P<0.001; 10.9+/-0.6 vs. 8.3+/-0.5 mm girth increment; P=0.009). Scintigraphy showed no differences in colonic gas distribution and no ileal gas reflux, but patients exhibited impaired gas clearance from the proximal colon (63%+/-10% clearance in 30 min vs. 80%+/-2% in health; P=0.042), resulting in more residual gas (506+/-46 vs. 174+/-47 ml; P<0.001), perception (1.9+/-0.2 vs. 1.0+/-0.2 score; P=0.015), and girth increment (4.2+/-0.7 vs. 2.2+/-0.5 mm; P=0.024); IBS-C patients exhibited increased sensation and objective distension, as opposed to sensation only in IBS-D and distension only in functional bloating.
Patients with abdominal bloating have normal colonic accommodation and ileocecal competence but impaired gas clearance from the proximal colon after retrograde infusion, and the consequences of this dysfunction are related to bowel habit.
我们旨在评估腹胀患者的结肠气体容纳、回盲瓣功能和结肠清除能力。
研究纳入 36 名腹胀患者（12 名便秘型肠易激综合征（IBS-C）、12 名腹泻型肠易激综合征（IBS-D）和 12 名功能性腹胀）和 18 名健康对照者。在直肠内以 24ml/min 的速度持续输注气体 1 小时（容纳期）和 30 分钟自由直肠气体排空（清除期）期间，测量腹部感知和周长。在 8 名患者和 8 名健康受试者中，输注的气体用放射性氙（74MBq（133）Xe）标记，并通过闪烁照相术确定气体分布。
与健康对照组相比，结肠气体容纳期在患者中引起了更明显的腹部症状和腹胀（感知评分 3.8+/-0.2 比 2.4+/-0.3；P<0.001；周长增加 10.9+/-0.6 比 8.3+/-0.5mm；P=0.009）。闪烁照相术显示结肠气体分布和回肠气体反流无差异，但患者近端结肠气体清除能力受损（30 分钟内清除率为 63%+/-10%，健康者为 80%+/-2%；P=0.042），导致更多残留气体（506+/-46 比 174+/-47ml；P<0.001）、感知（1.9+/-0.2 比 1.0+/-0.2 评分；P=0.015）和周长增加（4.2+/-0.7 比 2.2+/-0.5mm；P=0.024）；IBS-C 患者表现出感觉和客观腹胀增加，而 IBS-D 患者仅表现出感觉，功能性腹胀仅表现出腹胀。
腹胀患者的结肠气体容纳和回盲瓣功能正常，但逆行输注后近端结肠气体清除能力受损，这种功能障碍的后果与肠习惯有关。
